Sleep Apnea and Asthma Combo

[RomanDelta]

Hi All,

I have both "mild/moderate sleep apnea" and "mild but persistent asthma." As this point, both are untreated. Just got my Asthma meds last night. I tried a CPAP but I could not tolerate it, so I am having a MAD custom made by an orthodontist ($2,500 so it better work).

Anyway, I am curious exactly how badly you all felt before OSA treatment, especially those of you who also have asthma as well. I'll give you an example; I get tired from things as basic as walking from my office to the break room, which is about the length of a football field. I am not gasping for air or panting, but I definitely notice symptoms that suggest my respiratory system is working (little woozy in the head, feel like I need to take a feel good deep breaths, brain low on oxygen). Once I get back to my desk and sit for a minute or two I feel better. I asked my father, who went years with undiagnosed sleep apnea (his machine is set at 12, if that gives you a gauge of his severity), and he said he didn't feel bad enough that walking made him tired like that, but other forms of exertion would. He is double my age.

I've had my heart checked as recently as 3 years ago and everything was fine then.

[Okie bipap]

Like you, I have mild persistent asthma. Normally, any asthma attack I may have is easily controlled with steroids and albuterol inhalation solution in a nebulizer. The symptoms you have mentioned are more in line with asthma than sleep apnea. Asthma is normally classified as either exercise induced or allergy induced. Unfortunately, I have both. Yours sounds like exercised induced asthma. Sleep apnea usually slows you down all day, not just when you exercise. During my last year of work, I began to have trouble staying awake at work. Most of my time was spent at a desk working on a computer. I could not sit and watch a movie on the TV or sit and read without falling asleep. Since starting treatment, I no longer feel sleepy during the day. My asthma has recently gotten better since I started seeing an allergy specialist and have added an inhaled steroid to my medication routine. On a side not, the amount of pressure required to hold your throat open has nothing to do with the severity of your sleep apnea. Pressure requirements are determined by the physical conditions in the throat and soft pallet.

[Janknitz]

I had pretty severe asthma, and CPAP has been a godsend. First because I am breathing clean, filtered air all night. Second because the humidity is adjustable. So when I have issues with my cough variant asthma, about the only time I don't cough is when I'm wearing my CPAP. I can actually sleep through exacerbations--for decades before I'd be unable to sleep for days when my asthma was flaring up. I can adjust the humidity as needed, which helps a lot, too.

I was having issues like you describe. Walking across a room was difficult. While CPAP helped, it was dietary changes that put my asthma in remission and I can walk miles without issue now (as long as it isn't too much uphill, because that's still a problem for my lungs). I am convinced that better quality sleep and oxygenation at night was a huge metabolism booster that allowed me to get benefit from other lifestyle changes.

CPAP is challenging to get used to, but totally worth it. If you have particular difficulty breathing out against pressure it may improve over time, and if it does not, a BiPAP which permits a lower expiratory pressure may help.

If you intend to use only a mandibular appliance, be sure you get tested with it to make sure it's really helping. Alternatively, it may help you get by with a lower pressure range that is more tolerable.